Application Form

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Name
Surname
Birth Date
Passport No.
Citizenship
Music SchoolUniversity
Current Teacher
Telephone
Address
Color PhotoOnly jpg, png
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Copy of passportOnly jpg, png
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Copy of Payment receiptOnly jpg, png
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Application Fee:  [field41] GEL

For USD Transfer
Beneficiary Bank: JSC TBC Bank, Tbilisi, Georgia, SWIFT: TBCBGE22
Ben’s IBAN: GE27TB7066136180100005
Name of Beneficiary: LTD "Classical Music Development Fund"
Intermediary Bank: Citibank N.A. New York, USA, SWIFT: CITIUS33, ABA: 021000089
Intermediary Bank: Deutsche Bank Trust Company Americas, New York, USA, ABA: 02001033
Program
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Education Background of Applicant
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Previous Prizes and Awards
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Required Documents: a) Online Application b) Color Photo c) Copy of Passport d) Copy of Payment Receipt
Name of Guardian

Name of guardian is required if applicant is under 18 years old!

Waiver and Release Agreement

Waiver and Release AgreementAccording to this Waiver and Release Agreement (hereinafter referred to as“Agreement”), I hereby acknowledge and agree that: a) in order to be allowed toparticipate in the T. Amirejibi Borjomi International Piano Competition (hereinafterreferred to as “Competition”), I give up my rights to hold the organizers,managers, their employees and jury members liable for any injury that I maysuffer while participating in the Competition; b) by signing this agreement, I amassuming full responsibility for all risk while participating in the Competition.I am committed to follow the instructions and rules set by the organizers, and Iwill not withdraw at any time from the Competition without the consent of theorganizers. I agree to allow the organizers to use my biography, my photos andvideo footages during the entire competition for promotional and commercialpurposes. I promise to provide correct information about myself.I hereby declare that I am the contestant. I have read this agreement, understandit and agree to be bound to it as a contract (Signature of guardian is required ifapplicant is under 18 years old).
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